PPH术及RPH术联合外剥内扎术治疗重度混合痔疗效评估

Outcome between PPH and RPH Combined with Haemorrhoidectomy in Treatment of Severe Mixed Haemorrhoids

目的:比较吻合器痔上黏膜环形切除术(PPH)及自动套扎术(RPH)联合外剥内扎术治疗重度混合痔的疗效。方法:将我院98例重度混合痔患者随机分为P组(n=53)和R组(n=45);P组给予PPH联合外剥内扎术治疗,R组给予RPH联合外剥内扎术治疗。比较两种术式术后疗效、手术后并发症情况。结果:手术时间、术中出血情况、住院时间P组明显少于R组;但住院费用P组高于R组(P<0.05);术后出血、尿潴留、肛缘水肿、肛门坠胀感方面,R组较P组发生率较高(P<0.05)。术后患者肛门疼痛恢复周期及创面愈合时间比较中,P组较R组具有明显优势(P<0.05)。结论:PPH术联合外剥内扎术治疗重度混合痔的疗效优于RPH术联合外剥内扎术,且具有手术时间短、出血量少、恢复快、并发症少等优点。

Objective：To observe the clinical effect on treating severe mixed haemorrhoids between PPH and RPH combined with hemorrhoidectomy.Methods：A total of 98 patients with severe mixed haemorrhoids were randomly divided into P group（53cases）and R group（45cases）,the P group underwent PPH combined with Haemorrhoidectomy,while the R group underwent RPH combined with Haemorrhoidectomy,then the curative effect and complication of surgery were compared between the two groups.Results：The P group were superior to the R group in the operation time,bleeding in operation,hospital stays and the cost of hospitalization（P〈0.05）.The results showed that the operation time,bleeding in operation and the hospital stays in the P group were significantly less than that in the R group,but the cost of hospitalization was higher in the P group than in the R group.The incidences of postoperative bleeding,retention of urine,edema of the anal margin,and the feeling of the anus in the R group were higher than that in the P group（P〈0.05）.Compared with the postoperative anal sensory recovery cycle and wound healing time of the two groups,the results showed that the P group was significantly better than the R group（P〈0.05）.Conclusion：The curative effect of PPH combined hemorrhoidectomy in the treatment of severe mixed hemorrhoids is better than that of RPH combined with hemorrhoidectomy,and the former operation having the advantages of shorter operation time,less bleeding,faster recovery,less complications and so on.